FRT Aug Training Part 1

1. FRT AUGUST TRAINING Maj Gacioch FRT Team Chief Part 1: Cold Weather Injuries

2. Cold Weather Cold decreases your ability to think and weakens your will to do anything except to get warm. Cold is an insidious enemy; as it numbs the mind, it subdues the will to survive. Cold makes it very easy to forget your ultimate goal – to survive. FM 21-76 (Survival), Pg 15-1 2

3. Typical Victim of a Cold Weather Injury Male A1C or below 20 years old (approximately) From a warm climate Less than 18 months time in service Uses tobacco, alcohol or medications Neglects proper foot care 3

4. General Protection Use multiple layers, loose enough to trap air Cover your head (can lose 40-45% of body heat from head, and even more from neck, wrists and ankles Outermost layer should be wind/water resistant Consider higher protein/fat foods for calories Consider portable heaters, glove warmers, etc C- Keep clothing clean O- Avoid overheating L- Wear clothes loose and in layers D- Keep clothing dry 4

5. Factors Increasing Risks The body is better at losing heat than producing it Taking certain drugs or medications such as alcohol, nicotine, caffeine, and medication that inhibit the body's response to the cold or impairs judgment Having a cold or certain diseases, such as diabetes, heart, vascular, and thyroid problems (may make a person more susceptible to the winter elements ) Male sex (♂ have far greater mortality from cold than ♀ , perhaps due to inherent risk-taking activities, body-fat composition or other physiological differences ) 5

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7. Hypothermia DEFINITION: lowering of body temperature at a rate faster than the body can produce heat Initial symptom is shivering, sign is progressive pallor of skin in extremities At 96 degees F – shivering progresses to the point of being uncontrollable. Patient can’t care for self At 95-90 degees F – sluggish thinking, irrational reasoning, & false perception of warmth. Weak pulse At 90 – 86 degees F or less symptoms include muscle rigidity, unconsciousness & barely detectable signs of life (inaudible heart beat & pulse, unreactive pupils, very slow respirations 7 Mild Moderate Severe

8. Frostbite DEFINITION: Freezing of tissues. Light frostbite produces areas of dull, whitish, pallor that are numb when cold and burn when rewarmed “ chillblains ” Tend to occur on thin skin (face, feet & hands). Counter effect by covering, wiggling (making faces) and periodically exposing to heat. 8

9. Severe Frostbite 9

10. Trenchfoot Exposure for many hours or days to wet/damp at near freezing temperatures Presents as pins & needles sensation  tingling  numbness  pain Skin appears wet, soggy, wet, white & shriveled. As damage occurs  red  bluish  black in color. Walking becomes difficult. Muscles & tendons  become damaged. If persists long enough  can progress to gangrene and possibly amputation. Prevention is keeping feet warm and dry. Change socks frequently! 10

11. Trench Foot (Mild to Severe) 11

12. Trenchfoot Treatment prevent further exposure dry carefully DO NOT break blisters, apply lotions, massage, expose to heat, or allow to walk on injury rewarm by exposing to warm air clean and wrap loosely elevate feet to reduce swelling evacuate for medical treatment 12

13. Cold Weather Survival DO Periodically check self/buddy for frostbite. Rewarm frostbite Keep injured areas from refreezing DON’T R ub injuries with snow d rink A lcoholic beverages T haw out deep frostbite if away from definitive care (better to leave it frozen) S moke 13

14. More Advanced Care If the person is conscious give hot, sweetened fluids (honey, dextrose or sugar) To treat hypothermia rewarm the whole body, starting with the trunk only in warm water (100-110 degrees F) then slowly stimulating peripheral blood flow Do not warm too rapidly – BEWARE “ afterdrop ” If warm-water submersion is not available, use naked-buddy treatment in a sleeping bag – BEWARE: monitor buddy for hypothermia 14

15. Other Cold Weather Risks Dehydration – fluid loss to expiration & sweating Cold Diuresis – cold increases urinary output so increase fluids 2L > normal amounts; Urine = Lt yellow Constipation –add fruit/fiber to induce BMs regularly Sunburn – skin is exposed to reflected rays from every direction. Aggravated at high altitude. Snow Blindness – ultraviolet rays reflected from snow cause sunburn to the eyes Eyes feel gritty  Pain that increases with eye movement  eyes become teary and reddened  headaches (often) Use sunglasses on bright days! 15

16. Carbon Monoxide Poisoning When oxygen in the body is replaced by carbon monoxide colorless , odorless, tasteless gas resulting from incomplete combustion Inadequate ventilation from engines, stoves, and/or heaters 16

17. Carbon Monoxide Poisoning Symptoms headache dizziness weakness excessive yawning ringing in ears confusion nausea 17 bright red lips, eyelids grayish tint in dark-skinned people drowsiness unconsciousness possibly death Treatment –move to fresh air immediately –– provide mouth-to-mouth resuscitation if victim is not breathing -Use supplemental oxygen, if available -Transport ASAP

18. 18 Valley Forge, December 1777